Patterns and Predictors of Frailty Transitions in Older Men: The Osteoporotic Fractures in Men Study.
Patterns and Predictors of Frailty Transitions in Older Men: The Osteoporotic Fractures in Men Study.
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DOI：
10.1111/jgs.15003
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发表时间：
2017-11
影响因子：
6.3
通讯作者：
Dam TT
中科院分区：
文献类型：
--
作者：
Pollack LR;Litwack-Harrison S;Cawthon PM;Ensrud K;Lane NE;Barrett-Connor E;Dam TT
描述一大群居住在社区的老年男性的脆弱转变的自然历史，并确定与更脆弱状态的进展或改善相关的预测因素。前瞻性队列研究。六个美国网站。5,086名65岁或以上的社区居住男子。脆弱性是在基线和4.6年后的平均水平上测量的。脆弱被定义为≥3：低瘦体重、虚弱、自我报告的疲惫、低活动水平和缓慢的步行速度；前脆弱由1-2个成分组成。对不同的多变量Logistic回归模型进行分析，以了解脆弱状态的进展和改善情况。在5086名男性中，8%的人身体虚弱，46%的人体弱多病，46%的人在基线时很健壮。在基线和随访之间，35%的人虚弱状态进展或死亡，56%的人虚弱状态没有变化，15%的虚弱或虚弱的参与者有所改善。然而，只有0.5%的人在两个水平上有所改善，从虚弱到稳健。在多变量模型中，与改善虚弱状态相关的因素包括较大的腿部力量、已婚和良好或优秀的自我报告健康，而存在任何日常生活能力(IADL)限制、低白蛋白水平或高IL-6水平以及存在慢性阻塞性肺疾病或糖尿病与改善虚弱状态的可能性降低相关。在这群居住在社区的老年男性中，虚弱状况的改善是可能的；然而，从虚弱到强壮的完全补救是罕见的。几个预测因素被确定为可能的干预目标，包括预防和改善对合并疾病的管理、预防IADL残疾、体育锻炼以及营养和社会支持。
To describe the natural history of frailty transitions in a large cohort of community-dwelling older men and identify predictors associated with progression to or improvement from states of greater frailty. Prospective cohort study. Six U.S. sites. 5,086 community-dwelling men aged 65 years or older. Frailty was measured at baseline and an average of 4.6 years later. Frailty was defined as ≥ 3 of the following: low lean mass, weakness, self-reported exhaustion, low activity level, and slow walking speed; prefrail as 1-2 components. Separate multivariable logistic regression models were analyzed for progression and improvement in frailty status. Of the 5,086 men, 8% were frail, 46% were prefrail, and 46% were robust at baseline. Between baseline and follow-up, 35% progressed in frailty status or died, 56% had no change in frailty status, and 15% of prefrail or frail participants improved. However, only 0.5% improved across two levels, from frail to robust. In multivariable models, factors associated with improvement in frailty status included greater leg power, being married, and good or excellent self-reported health, whereas presence of any instrumental activities of daily living (IADL) limitations, low albumin levels or high IL-6 levels, and presence of chronic obstructive pulmonary disease or diabetes mellitus were associated with a decreased likelihood of improvement in frailty status. Improvement in frailty status was possible in this cohort of community-dwelling older men; however, complete remediation from frail to robust was rare. Several predictors were identified as possible targets for intervention including prevention and improved management of comorbid medical conditions, prevention of IADL disability, physical exercise, and nutritional and social support.
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DOI：
10.1111/j.1532-5415.2010.03155.x
发表时间：
2010-12-01
影响因子：
6.3
作者：
Bean, Jonathan F.;Kiely, Dan K.;Leveille, Suzanne G.
通讯作者：
Leveille, Suzanne G.
影响因子：
5.4
作者：
UMBERSON, D
通讯作者：
UMBERSON, D
影响因子：
2.2
作者：
Orwoll, E;Blank, JB;Stone, K
通讯作者：
Stone, K
影响因子：
5.6
作者：
Johnson, NJ;Backlund, E;Loveless, CA
通讯作者：
Loveless, CA
DOI：
10.1093/gerona/glt196
发表时间：
2014-06-01
影响因子：
5.1
作者：
Shikany, James M.;Barrett-Connor, Elizabeth;Redden, David T.
通讯作者：
Redden, David T.